• Title/Summary/Keyword: 혈전제거술

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Comparative Analysis of Surgical Thrombectomy with Revision and Percutaneous Thrombectomy with Angioplasty for Treating Obstruction of a Dialysis Graft (인조혈관 동정맥루 폐쇄의 치료에서 수술적 혈전제거술 및 재건술과 경피적 혈전제거술 및 혈관성형술의 비교연구)

  • Lim, Jae-Woong;Won, Yong-Soon;Kim, Dong-Hyun;Shin, Hwa-Kyun
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.487-491
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    • 2009
  • Background: Salvaging prosthetic arteriovenous grafts can be performed using surgical or endovascular techniques. We conducted a retrospective analysis to compare the efficacy of these two methods for restoring dialysis graft function. Material and Method: We studied 41 patients who had received surgical thrombectomy with revision (Group A) or percutaneous thrombectomy with angioplasty (Group B) from January 2006 to December 2007. We compared them according to the patient characteristics and the location of stenotic lesions, and we analyzed the post-intervention primary patency rates. Result: 21 patients underwent surgery and 20 patients underwent percutaneous balloon angioplasty. There were no significant differences of the patients' characteristics between the two groups. Venous anastomotic stenosis was the most common cause of graft thrombosis in both groups. In Group A, 90.5% of the grafts remained functional at 6 months and 38.1% remained functional at 12 months. In Group B, 55.0% of the grafts were functional at 6 months and 20.0% of the grafts were functional at 12 months. The post-intervention primary patency rate was significantly better in Group A (p=0.034). Conclusion: Surgical treatment resulted in significantly longer post-intervention primary patency in this study, and this supports its use as the primary method of management for most patients in whom dialysis graft obstruction develops.

Thrombectomy of Superior Mesenteric Artery Occlusion - A case report - (상장간막 동맥 폐쇄증의 혈전 제거술- 1예 보고 -)

  • Lee, Seock-Yeol;Baek, Kang-Seock;Jeon, Cheol-Woo;Lee, Seung-Jin;Lee, Cheol-Sae;Lee, Kihl-Rho
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.641-644
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    • 2007
  • A 50-year old man was admitted to our hospital because he complained of sudden abdominal pain. Multidetector abdominal CT showed proximal occlusion of the superior mesenteric artery. Emergency open laparotomy and Fogarty thrombectomy were done on admission day and repeat Fogarty thrombectomy and partial resection of the small bowel were done the next day. We report here on a case of superior mesenteric artery occlusion.

Safety and Efficacy of the Percutaneous Manual Aspiration Thrombectomy Technique to Treat Thrombotic Occlusion of Native Arteriovenous Fistulas for Hemodialysis (혈액투석용 자가혈관 동정맥루의 혈전을 동반한 폐색에서 경피적 수동 흡인 혈전제거술의 안정성과 유용성)

  • Sang Eun Yoon;Sun Young Choi;Soo Buem Cho
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.409-417
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    • 2020
  • Purpose To evaluate the safety and efficacy of the percutaneous manual aspiration thrombectomy technique to treat thrombotic occlusion of native arteriovenous fistulas. Materials and Methods A retrospective review of 20 patients who underwent percutaneous manual aspiration thrombectomy for native thrombotic arteriovenous fistula occlusion from March 2012 to December 2017 was performed. We evaluated technical and clinical success rates and complications. The primary and secondary patency rates were calculated using the Kaplan-Meier analysis. Results Percutaneous manual aspiration thrombectomy was performed in 20 patients (n = 20) with concomitant balloon angioplasty. The overall technical and clinical success rates were both 85% (n = 17). The native arteriovenous fistulas, based on their site, were the left radiocephalic (n = 13), left brachiocephalic (n = 4), and right radiocephalic (n = 3) fistulas. An underlying stenosis was detected in the juxta-anastomotic venous site (n = 16), outflow draining vein (n = 12), and central vein (n = 4). The primary and secondary patency rates at 1, 3, 6, and 12 months were 100%, 70.6%, 70.6%, and 56.5% and 100%, 94.1%, 94.1%, and 86.9%, respectively. There were no complications associated with procedure. Conclusion Percutaneous manual aspiration thrombectomy is a safe and effective method to treat thrombotic native arteriovenous fistula occlusion.

Malignant Thrombi of Inferior Vena Cava from Renal Cell Carcinoma -4 cases reports- (신세포암에 의한 하대정맥 악성 혈전 -치험 4례-)

  • 홍종면;김오곤;이석재;노윤우;이조한;홍장수;김원재;임승운;안재호
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1097-1101
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    • 1998
  • Renal cell carcinoma involves the inferior vena cava(IVC) in approximately 5-10% of the patients. Presently surgical extirpation is the only form of therapy that can result in cure. Circulatory arrest with cardiopulmonary bypass is an operative technique that recently has been used to assist in resection of tumors that extend into the vena cava above the level of hepatic veins. We performed removal of tumor thrombi of IVC in 4 patients. All of them who had the renal cell carcinormas with infrahepatic vena caval extension were performed by standard surgical technique without cardiopulmonary bypass. But in one patient, inferior vena caval thrombectomy was done using circulatory arrest because of the recurred extension of the tumor thrombi within the vena cava above the insertion of the hepatic vein. All patients were recovered without any significant problems.

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Massive Endorobronchial Hemorrhage After Pulmonary Thromboendarterectomy in Chronic Pulmonary Embolism (만성 폐색전증에서 색전제거술을 시행한 후 발생한 기관지내 대량 출현)

  • 정동섭;김기봉
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.373-376
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    • 2001
  • 만성 폐색전증으로 혈전 제거술을 하고 난 다음 기관지내 대량 출혈은 빈도는 적으나 상당히 높은 사망률을 보이는 합병증 중의 하나이다. 기관지내 대량 출혈이 생겼을 때 체외 막 산소화 장치와 각각 다르게 조절한 인공호흡기 2대를 이용하여 특별한 휴유증 없이 잘 치료한 경험을 하였기에 보고하는 바이다.

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Thrombectomy of Femoro-Femoral Bypass Graft Occlusion Using the AngioJet Rheolytic Thrombectomy System and Embolic Protection Device: A Case Report (대퇴-대퇴동맥 우회 인조혈관 폐색에서 AngioJet Rheolytic Thrombectomy System과 색전보호기구를 이용한 혈전제거술: 증례 보고)

  • Han Sol Kang;Sangjoon Lee;Soon-Young Song;Eung Tae Kim;Seong Eun Ko;Sung Min Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.447-454
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    • 2021
  • The authors report a successful thrombectomy using the AngioJet Rheolytic Thrombectomy System (AngioJet) and an embolic protection device in a patient with femorofemoral bypass graft occlusion. Lower extremity CT angiograms showed occlusion in the left-to-right femorofemoral bypass graft. A rheolytic thrombectomy using the AngioJet and balloon angioplasty restored blood flow to the right lower extremity, and distal embolization may be effectively prevented by placing an embolic protection device within the right superficial femoral artery during the procedure.

Aspergillus Infection in Large Thrombus of a Permanent Ventricular Pacing Lead (영구 인공심박동기 심실전극의 거대혈전에 발생한 국균증)

  • Kim, Chi-Gyeong;Jo, Gyu-Do;Yun, Jeong-Seop;Kim, Jin-Ho
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.1032-1035
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    • 1997
  • Fungal infection of intracardiac pacing wire is very rare. We experienced a case of patient with functioning transvenous pacemaker lead, inserted 3 years previously, which was completely encased in a large thrombus infected with aspergillus. The lung biopsy also confirmed aspergillus infection.

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Risk Factors and Clinical Outcomes of Brain Reperfusion Injury after Mechanical Thrombectomy for Ischemic Stroke (기계적 혈전제거술을 시행한 허혈성 뇌졸중 환자의 뇌재관류 손상 위험요인과 임상결과)

  • Moon, Ji Hyun;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.23 no.3
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    • pp.217-226
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    • 2021
  • Purpose: The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes. Methods: A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher's exact test, and logistic regression with IBM SPSS/WIN 24.0. Results: Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome (𝛘2=6.01, p=.014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR]=1.14, 95% Confidence interval [CI]=1.06-1.23), aphasia (OR=6.16, CI=1.62-23.40), anosognosia (OR=4.84, CI=1.13-20.79), presence of both aphasia and anosognosia (OR=7.33, CI=1.20-44.60), and time required to achieve targeted blood pressure (OR=1.00, CI=1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation (𝛘2=6.32, p=.012), intensive care unit length of stay (Z=-2.08, p=.038), National Institute of Health Stroke scale score at discharge (Z=-3.14, p=.002), and modified Rankin Scale score at discharge (Z=-2.93, p=.003). Conclusion: This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.

Surgical Technique thor the Removal of Deep Vein Thrombi of the Lower Extremities (하지 심부정맥 혈전의 외과적 제거)

  • 이상호;최준영;김성호;김병균;장인석;이정은;옥창대;김종우;나재범
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.402-406
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    • 2002
  • The conventional surgery method of thrombectomy of venous thrombi from the deep veins of the lower extremity was the use of Forgarty balloon catheter. The catheter is inconvenient due to the presence of the balloon and prohibiting venous valves within the venous trees. With the use of a stone-forceps(Fig. 1), thrombi within iliofemoral vein could be easily removed without the obstacle of the valves because the instrument keeps valves open. This instrument is also useful in monitoring the back-flow from the iliac vein. Thrombi within the veins below the level of inguinal incision are removed successfully only by effective manual compression of the calf and thigh muscles. 1 recommend operating on the iliac vein first rather than the lower venous tree.

Surgical Treatment of Lemierre′s Syndrome -A case report- (Lemierre 증후군의 수술 치험 -1례 보고-)

  • 오정훈;이정철;이동협;이장훈;정태은;한승세
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.644-647
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    • 2001
  • Lamierre's syndrome is characterized by a rare fulminant condition resulting from primary oropharyngeal infection followed by secondary septic thrombophlebitis of the internal jugular vein and metastatic infection. A forty-year-old man who had been on ventilator due to servere chest trauma, showed severe reddish inflammatory swelling of the right cervical soft tissue and newly developed pneumonia. He went into in septic condition shortly thereafter. Thrombophlebitis with central abscess in the right internal jugular vein was identified by neck CT and MRA(magnetic resonance angiography). Right cervical swelling worsened in spite of clindamycin and heparin therapy. We performed immediate surgery for removal of septic thrombus and resection of internal jugular vein. Patient's septic condition, pneumonia, and local inflammatory reaction were improved within several days after surgery.

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